University of Virginia School of Medicine
Clinical Medicine Committee
- Members present (underlined): Donald Innes; Reid Adams; Michael Rein; Karen Maughan; Pamila Herrington; Vern Juel; Jennifer Wenger; Jerry Short; Eugene Corbett; Meg Keeley; Gary Owens; Allison Innes; William Petri; Susan Squillace; Evan Heald;Clive Bradbeer; Ann Chapin; William Wilson
- The meeting was called to order at 5 PM in the Pediatrics-Pathology Conference Room.
- The issue of "call" on the 3rd year clerkships was discussed. There are no existing guidelines regarding "call" that applies to all of the clerkships and sites, and the amount and nature of "call" varies.
AIM: Call is at the discretion of the preceptor
Pediatrics: Usually every 4th night on inpatient services. No "call" on outpatient rotations, other than for students who have an evening (5-11PM) rotation in the Pediatrics Emergency Room
Psychiatry: 4 total call nights during the 6 week rotation, on "beeper"
Medicine: Every 4th night. This may be modified as adjustments to the call system for residents are made next year.
OB/GYN: Every 3-4 nights during the Obstetrics portion of the clerkship
Surgery: Averages every 3-4 nights
Neurology: 1 time during the 4 week rotation
It was agreed that "call" is an important part of a clerkship, particularly on inpatient rotations. Students may be more likely to see "new" patients and more acute presentations of diseases, and may participate in the initial assessment of these patients and then follow their progress. It is also important to give our students the opportunity to work directly with the house-staff in an on-call situation.
We also reviewed the timing of the ending of clerkship responsibilities relative to the final end-of-clerkship examinations. None of the clerkships require students to be "on call" the night before an examination.
- The "clinical skills passports" were discussed. These have met with mixed reviews on some services, with some students not having their passports completed at the end of their rotations. Other clerkships have reported better acceptance and compliance. It is felt that the passports may be achieving the stated goal of improving contact between students and faculty, and improving feedback. The passport program will continue to be reviewed, and the individual clerkships may want to modify their passports for the upcoming clerkship year.
- Dr. Heald shared a concern that had been expressed by a preceptor regarding the items on the clerkship evaluation forms used by students that refer to statements that make men/women or minorities uncomfortable. Dr. Short reviewed the mechanism by which the Office of Medical Education reviews these concerns. Narrative descriptions and comments are more helpful to his committee in evaluating these incidents. It is felt that students need to have avenues to bring these concerns to the clerkship directors or to the Office of Student Affairs. Consistency and patterns of behavior are important. It was agreed that these items need to be maintained in the student evaluation forms, and that there were mechanisms in place to assess the significance of incidents, as well as additional ways in which students could express their concerns.
- Dr. Allison Innes mentioned the Gold Foundation Honor Society for Humanism for medical students. More information about this program will be forthcoming.
- Dr. Keeley reviewed the ACE (Advanced Clinical Electives) program which will begin with the next elective year. Most of this year's 4th year students are already taking an elective that would qualify as an "ACE", but 35 students are not. The ACE program electives will give students increased responsibility for patient care and will facilitate the transition between medical school and residency training.
- We reviewed grading using the new student evaluation form that has been used since July. While each clerkship may have different methods of using the evaluation and ratings, it is important that there be consistency within a clerkship.
- The meeting was adjourned at 6:05 PM.
- Respectfully submitted,
- William G. Wilson, MD
- Chair, Clinical Medicine Committee